Archived: Human Support Group Limited - Westfields

Human Support Group Limited – Westfields (Westfields) is a domiciliary care provider registered to provide personal care support to people living within an extra care scheme. An extra care scheme is similar to sheltered housing but with additional care and support provided to meet people’s individual needs. At Westfields the housing component is separate from the care services and is provided and managed by another organisation called The Anchor Group (Anchor) who employs housing managers to take care of the premises including maintenance and gardening. In an email, the Manchester local authority commissioning team told us, “The objective of the extra care service at Westfields is to offer a ‘Home for Life’ flexible service, responsive to the changing care needs of our customers, providing support when required and at all times promoting their health, independence, welfare and human rights.”

Care staff support people living at the property in their own tenancies with a wide range of personal care needs and domestic duties, including assistance with shopping, meal preparation and home cleaning. As well as providing care to people assessed as needing it, the care team is also responsible for any identified short term care needs of anyone living at Westfields.

There are 48 apartments at Westfields and at the time of our inspection 27 people were receiving an element of personal care and support. The local authority commissions a specific number of hours for the delivery of care and support from Human Support Group Limited and these hours are distributed amongst the people identified as requiring support.

Westfields is located in the Baguley area of Manchester and has good transport links to the city centre and nearby town of Wythenshawe. Local amenities within walking distance include a supermarket, a post office, a park and leisure facilities.

At the time of this inspection, there was a manager in post who had registered with the Care Quality Commission since May 2017. The registered manager also managed another extra care scheme nearby. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they received care and support that was safe. Relatives we spoke with confirmed their loved ones received safe care.

People and their relatives told us staff demonstrated good hygiene practices by using personal protective equipment (PPE) such as gloves and aprons. We observed one example of unsafe practice according to current infection prevention guidance. The registered manager provided suitable assurances to address the issue immediately. We recognised that staff were aware of cross contamination and promoted good infection control in some respects, however there were areas which required further improvement. At inspection, the registered manager provided suitable assurances that this issue would be addressed in supervision and at team meetings.

There were sufficient staff deployed at Westfields to help ensure people were supported according to their needs and the provider had robust recruitment processes which helped to ensure suitable staff were employed.

Risk assessments were in place and contained sufficient details and guidance to help ensure people were supported safely.

There were suitable systems to help ensure people were protected from harm. Staff were well-informed about the types of abuse and the action they would take if they suspected that abuse was taking place. This meant people using the service were protected from harm due to organisation systems and staff knowledge.

We saw accidents and incidents were recorded and appropriate action taken to reduce the risk of any reoccurrence. The registered manager had recently implemented a separate falls monitoring system to improve management oversight of the service and help ensure incidents were managed and addressed more proactively. This meant the service had appropriate systems in place to keep people safe from harm.

There was a consistent staff team at Westfields. This meant people were supported by staff who knew and understood their needs.

Some people required support to take their medicines. Records demonstrated staff were suitably competent to carry out the task and did so safely. The service used a medication support plan and risk assessment which helped staff to support people in a safe way.

People told us staff were competent. Staff received an induction and mandatory training prior to working with people. There was evidence that staff were supported with on-going and refresher training as required. Staff received regular supervisions and appraisals to help ensure they received the necessary support to carry out their roles. Staff we spoke with confirmed this. This meant staff had the right knowledge and skills and received continuous support to function effectively in their caring role.

The registered manager had a good understanding of Mental Capacity Act 2005 (MCA) and how this legislation should be used to protect people. Staff sought people’s consent before undertaking tasks and people confirmed this was the case. Staff told us if they had concerns about people’s mental capacity they would raise this with management and also inform involved family members. The registered manager told us support from social work professionals and GPs was sought if they suspected a person lacked capacity.

Support plans indicated that consent to care had been sought appropriately. We found minor discrepancies with how consent to care was recorded which we pointed out to the registered manager. We noted however the provider had updated their documentation in this regard to better reflect that relatives had been involved in the care planning process. We concluded there was sufficient evidence to demonstrate the service had systems in place to help ensure people’s rights were protected.

There were formal systems in place to ensure staff had the skills and competencies necessary to carry out their responsibilities and that they received adequate professional support. The provider had a robust induction programme in place which was aligned to the nationally recognised care certificate induction standards. Staff also undertook training considered mandatory by the provider which included safeguarding, personal care and medication. Refresher training was scheduled to help ensure staff kept up to date with the knowledge and skills required to perform effectively in their support roles.

People told us the service supported their access to health care professionals and medical attention, if required. In the case of an emergency, medical attention was sought and relatives contacted. This meant people were supported in a proactive way to receive the right health care when they needed.

Where needed, people told us staff supported them with their food preparation. Everyone we spoke with told us they were happy with the support provided. They said staff always consulted them prior to carrying out the task and that they had a choice. This helped to ensure people maintained good nutrition and hydration.

People told us staff were kind and caring. We observed warm and caring interactions between people and the staff supporting them. These interactions extended to everyone living at the scheme and not just those receiving the regulated activity of personal care.

Staff demonstrated that they knew and understood the needs of the people they supported, as well as those living at the scheme.

People had been involved in making decisions about the support they received. Care records we reviewed confirmed this. This meant that people and their relatives, where appropriate, were included in making decisions about the support provided.

People were encouraged to develop and maintain their independence according to their abilities. This helped to ensure that they maintained a good quality of life and wellbeing.

Support plans contained personal information about people, their preferences, personal goals and how they wanted to be supported. Most care plans we looked at contained detailed descriptions of support provided to help ensure care provided was person centred.

People were engaged in activities which they enjoyed which helped to ensure improved quality of life and wellbeing.

There was an up to date complaints procedure in place and people and relatives told us they were aware of how to raise a complaint. They said any concerns they raised were resolved satisfactorily. People and their relatives were complimentary about the service and we saw several cards had been sent to the service to show their appreciation to staff and management.

People and relatives had the opportunity to provide feedback about the service provided. We noted the service had sent out customer satisfaction surveys in November 2016 and May 2017and the results of these were positive.

People told us they would recommend this service to others and some had done so.

The provider had quality assurance systems in place to monitor, for example, staff performance, support plans and medication administ

There are 43 individual flats at Westfields but at the time of our inspection only 24 people were receiving an element of personal care and support. The local authority commissions a specific number of hours for the delivery of care and support from Human Support Group Limited – Westfields - HCSA and these hours are distributed between people identified as requiring support.

At each apartment we visited, people were supported with their personal care needs to enable them to live in their own homes and promote their independence, whilst living in an environment that offered companionship, a social life, security and privacy. People were able to socialise in the communal areas, whilst still enjoying privacy in their own apartments.

A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.'

At the time of our inspection Human Support Group Limited – Westfields – HCSA did not have a registered manager. The previous registered manager had left in December 2015. The provider had appointed an assistant manager in April 2016 who had started the application process to be the registered manager. Staff we spoke with felt supported by management and had no problems raising any issues or concerns with senior management.

People had a joint assessment carried out by both the care provider and the housing provider prior to receiving a service. Risks were identified by the care provider before the commencement of care. How to manage those identified risks was made clear for staff as risk assessments were in place that covered various aspects of care and support.

People using the extra care service told us they felt safe. Discussions with staff and examination of training records confirmed that staff had access to safeguarding training and demonstrated a satisfactory understanding of the different types of abuse. They would have no concerns in reporting suspected abuse to their manager.

We looked at staff rotas and found that staffing levels were sufficient across the extra care scheme to safely meet the needs of people who used the service. Some periods of care were busier than others, for example, during morning times, but staff did not seem rushed. We saw that staff had space between morning and lunch calls which the service referred to as ‘downtime’. This time was spent in communal areas which were not used by people at the time of our inspection. People we spoke with were satisfied with the levels of care.

We looked at how the service managed the administration of medicines and looked at medication administration records (MARs) for people who used the service. Policies and procedures were in place covering all aspects of medicines management including the ordering, receipt, administration and disposal of medicines. The service had recently revised its practice on the storage of medicines and this was now more robust.

People and their relatives told us that they were involved in the planning of their care and they consented to their care and treatment. Records confirmed that people had consented to their care and had been involved in the assessment of their needs. People we spoke with told us that staff were caring and compassionate toward them. Care workers could demonstrate that they knew people well, as they could describe their likes, dislikes and preferences, although documentation of these in care plans was limited.

People and their relatives told us that care workers were caring and supported people’s privacy and dignity. Care workers we spoke with could give examples of how they promoted people’s independence and we saw examples of this during our visits to people’s apartments.

Staff were recruited safely and there were Disclosure and Barring Service (DBS) checks undertaken for staff in the files we looked at. Staff were subject to a formal induction plan which was repeated following any long term absence, for example through sickness or maternity leave. Refresher training was undertaken by staff at intervals determined by the company and dependant on the type of training. Medicines administration refresher training was out of date for six staff at the time of our inspection.

A suitable disciplinary policy was in place and we saw evidence in staff personnel files of the disciplinary policy being appropriately followed.

The service was working within the principles of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) and staff had completed training in these areas.

The registered provider had a complaints policy to provide guidance to staff and people using the service and / or their representatives. None of the people or relatives we spoke with had made a formal complaint. Records showed that the service acted upon the written complaints it had received in 2015 in accordance with their complaints policy. People’s personal information was stored securely and appropriately.

Staff meetings were held and we saw minutes from these meetings. The service had started undertaking spot checks of staff and staff supervisions and we saw copies of these on individuals’ personnel files. The registered provider had internal policies and procedures to provide guidance to staff on 'safeguarding vulnerable adults' and 'speaking out at work' (whistle blowing).

The service worked in partnership with other organisations to ensure that appropriate care and support was provided to people in relation to their changing needs including GP’s, pharmacists, social workers and other health professionals.